– Week 2 –
Healthcare systems
PUBH1382
Learning objectives
1. Understand the concept of health professionals and their regulation in Australia
2. Understand concepts related to types of health care systems and their reform
(refer to Tuohy theory 1999).
3. Explain the following concepts related to the Australian public health care system
a) Medicare
b) Pharmaceutical Benefits Scheme
c) Private health care system
4. Relate the US and the UK health care systems to the Australian health care
system.
Australia’s Health 2016 – a snapshot
Page 3
Australia’s Health 2016 – a snapshot (2)
Page 4
1. Health professionals
Professionalisation
Page 6
Friedson’s (1970) definition of a profession
Page 7
Principles of professionalism
http://blog.ncpad.org/2013/05/09/principles-of-professionalism/
Page 8
Australian Health Practitioners Registration
Authority (AHPRA)
Page 9
ACTIVITY
Go to www.ahpra.gov.au
Look at the 14 National Boards
http://www.ahpra.gov.au/Health-Professions.aspx
Is your chosen profession managed by AHPRA?
Page 10
2. Health care systems and reform
The welfare, market or mixed health care
system – Caroline Tuohy (1999)
Page 12
Health care reform
Page 13
Economic rationalism – New Public
Management
Page 14
Economic rationalism – New Public
Management (1)
- Advantages
- efficiency, effectiveness, economy
- disaggregation of large government bureaucracies
- Disadvantages
- Reduction of services – just the essentials
- Fragmentation of services – complex cases treated by
separate systems.
Page 15
Economic rationalism – New Public
Management (2)
Page 16
Total health care spending 2014
https://data.oecd.org/healthres/health-spending.htm#indicator-chart
Page 17
Life expectancy at 65 years (2013)
https://data.oecd.org/chart/4DZR
Page 18
3. Medicare, PBS & Private health
care
Medicare
Page 20
What Medicare funds
Page 21
Pharmaceutical Benefits Scheme (PBS)
Page 22
Private health care
Page 23
Private health care
Page 24
4. US & UK health care
UK health system
Page 26
US Health system
- Market model
- Privately funded
- Employers often pay
- Medicare (for elderly)
- Medicaid (for poor)
- Obamacare (Affordable Care Act) –
designed to ensure all are insured.
Page 27
Australia’s mixed - No fee at public hospitals
model – a real mix
- Fee for service at private
hospitals
- Many health professionals work
across both
- Bulk billing
- GPs and specialists can charge
the ‘market rate’
- Private health insurance optional
- Patients pay ‘gap’
- Funded by taxpayer and
Video explainer: Medicare levy and Medicare levy individual
surcharge (also in Course Notes)
- Private dental, ambulance
http://www.youtube.com/watch?v=3_dDDfoajZM
Page 28
Australian Health Care System
– Week 2 –
Healthcare systems
PUBH1382